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Letters

Fever in our First Nations

Janet Gordon, Mike Kirlew, Raphael Saginur, Natalie Bocking, Len Kelly, Christine Kennedy, Terri Farrell and Yoko Schreiber
CMAJ September 22, 2015 187 (13) 996; DOI: https://doi.org/10.1503/cmaj.1150058
Janet Gordon
Sioux Lookout First Nations Health Authority (Gordon, Farrell); Division of Clinical Sciences (Kirlew), Northern Ontario School of Medicine, Sioux Lookout, Ont.; Division of Infectious Diseases (Saginur), The Ottawa Hospital, Ottawa, Ont.; Public and Preventive Medicine (Bocking), University of Toronto, Toronto, Ont.; Sioux Lookout Meno Ya Win Health Centre (Saginur, Kelly), Sioux Lookout, Ont.; Northern Ontario School of Medicine (Farrell), Sudbury, Ont.
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Mike Kirlew
Sioux Lookout First Nations Health Authority (Gordon, Farrell); Division of Clinical Sciences (Kirlew), Northern Ontario School of Medicine, Sioux Lookout, Ont.; Division of Infectious Diseases (Saginur), The Ottawa Hospital, Ottawa, Ont.; Public and Preventive Medicine (Bocking), University of Toronto, Toronto, Ont.; Sioux Lookout Meno Ya Win Health Centre (Saginur, Kelly), Sioux Lookout, Ont.; Northern Ontario School of Medicine (Farrell), Sudbury, Ont.
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Raphael Saginur
Sioux Lookout First Nations Health Authority (Gordon, Farrell); Division of Clinical Sciences (Kirlew), Northern Ontario School of Medicine, Sioux Lookout, Ont.; Division of Infectious Diseases (Saginur), The Ottawa Hospital, Ottawa, Ont.; Public and Preventive Medicine (Bocking), University of Toronto, Toronto, Ont.; Sioux Lookout Meno Ya Win Health Centre (Saginur, Kelly), Sioux Lookout, Ont.; Northern Ontario School of Medicine (Farrell), Sudbury, Ont.
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Natalie Bocking
Sioux Lookout First Nations Health Authority (Gordon, Farrell); Division of Clinical Sciences (Kirlew), Northern Ontario School of Medicine, Sioux Lookout, Ont.; Division of Infectious Diseases (Saginur), The Ottawa Hospital, Ottawa, Ont.; Public and Preventive Medicine (Bocking), University of Toronto, Toronto, Ont.; Sioux Lookout Meno Ya Win Health Centre (Saginur, Kelly), Sioux Lookout, Ont.; Northern Ontario School of Medicine (Farrell), Sudbury, Ont.
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Len Kelly
Sioux Lookout First Nations Health Authority (Gordon, Farrell); Division of Clinical Sciences (Kirlew), Northern Ontario School of Medicine, Sioux Lookout, Ont.; Division of Infectious Diseases (Saginur), The Ottawa Hospital, Ottawa, Ont.; Public and Preventive Medicine (Bocking), University of Toronto, Toronto, Ont.; Sioux Lookout Meno Ya Win Health Centre (Saginur, Kelly), Sioux Lookout, Ont.; Northern Ontario School of Medicine (Farrell), Sudbury, Ont.
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Christine Kennedy
Sioux Lookout First Nations Health Authority (Gordon, Farrell); Division of Clinical Sciences (Kirlew), Northern Ontario School of Medicine, Sioux Lookout, Ont.; Division of Infectious Diseases (Saginur), The Ottawa Hospital, Ottawa, Ont.; Public and Preventive Medicine (Bocking), University of Toronto, Toronto, Ont.; Sioux Lookout Meno Ya Win Health Centre (Saginur, Kelly), Sioux Lookout, Ont.; Northern Ontario School of Medicine (Farrell), Sudbury, Ont.
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Terri Farrell
Sioux Lookout First Nations Health Authority (Gordon, Farrell); Division of Clinical Sciences (Kirlew), Northern Ontario School of Medicine, Sioux Lookout, Ont.; Division of Infectious Diseases (Saginur), The Ottawa Hospital, Ottawa, Ont.; Public and Preventive Medicine (Bocking), University of Toronto, Toronto, Ont.; Sioux Lookout Meno Ya Win Health Centre (Saginur, Kelly), Sioux Lookout, Ont.; Northern Ontario School of Medicine (Farrell), Sudbury, Ont.
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Yoko Schreiber
Sioux Lookout First Nations Health Authority (Gordon, Farrell); Division of Clinical Sciences (Kirlew), Northern Ontario School of Medicine, Sioux Lookout, Ont.; Division of Infectious Diseases (Saginur), The Ottawa Hospital, Ottawa, Ont.; Public and Preventive Medicine (Bocking), University of Toronto, Toronto, Ont.; Sioux Lookout Meno Ya Win Health Centre (Saginur, Kelly), Sioux Lookout, Ont.; Northern Ontario School of Medicine (Farrell), Sudbury, Ont.
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In a CMAJ practice article, Bagnall and colleagues describe acute rheumatic fever in a member of Canada’s immigrant population.1 The same article correctly identifies Canada’s First Nations as a population at risk for this disease. Social determinants of health are contributory: poverty, inadequate housing and systemic neglect. The Sioux Lookout Acute Rheumatic Working Group recently identified eight cases of acute rheumatic fever in First Nations youth, including two young children for whom the disease was fatal.

We are at a crossroads in how we perceive and respond to the inequities present for First Nations communities in Canada. Deaths from acute rheumatic fever are preventable. Inadequate housing and overcrowding play a direct role in the incidence of acute rheumatic fever, a disease unheard of in the rest of Canada.

The social and health care needs of First Nations are apparent to the Truth and Reconciliation Commission of Canada,2 the United Nations,3 the Auditor General4 and the Senate.5 We suggest it is also of keen interest to Canadian physicians and their patients, who may be experiencing vast health and social inequities first hand.

References

  1. ↵
    1. Bagnall EM,
    2. Ho MJ,
    3. McCormick IA
    . A 39-year-old man with recurrent rheumatic fever. CMAJ 2015; 187:50–4.
    OpenUrlFREE Full Text
  2. ↵
    Truth and Reconciliation Commission of Canada [homepage]. Winnipeg. Available: www.trc.ca (accessed 2015 June 2).
  3. ↵
    Report of the Special Rapporteur on the rights of indigenous peoples, James Anaya: addendum on the situation of indigenous peoples in Canada.Geneva: United Nations; 2014. Available: http://unsr.jamesanaya.org/docs/countries/2014-report-canada-a-hrc-27-52-add-2-en-auversion.pdf (accessed 2015 June 2).
  4. ↵
    2015 spring reports of the Auditor General of Canada: Report 4 — access to health services for remote First Nations communities. Ottawa: Office of the Auditor General of Canada. Available: www.oag-bvg.gc.ca/internet/English/parl_oag_201504_04_e_40350.html (accessed 2015 June 2).
  5. ↵
    Interim report of the Standing Senate Committee on Aboriginal Peoples. Housing on First Nations reserves: challenges and successes. Ottawa: The Standing Senate Committee on Aboriginal Peoples; 2015. Available: www.parl.gc.ca/Content/SEN/Committee/412/appa/rep/rep08feb15b-e.pdf (accessed 2015 June 3).
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Canadian Medical Association Journal: 187 (13)
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Vol. 187, Issue 13
22 Sep 2015
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Fever in our First Nations
Janet Gordon, Mike Kirlew, Raphael Saginur, Natalie Bocking, Len Kelly, Christine Kennedy, Terri Farrell, Yoko Schreiber
CMAJ Sep 2015, 187 (13) 996; DOI: 10.1503/cmaj.1150058

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Fever in our First Nations
Janet Gordon, Mike Kirlew, Raphael Saginur, Natalie Bocking, Len Kelly, Christine Kennedy, Terri Farrell, Yoko Schreiber
CMAJ Sep 2015, 187 (13) 996; DOI: 10.1503/cmaj.1150058
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